Carta al editor / Revisión por pares

This study examines the feasibility of adapting the Family Check Up (FCU), an evidence-based program to identify and manage behavioral concerns in children ages 4 and 5 years, within a pediatric primary care clinic with an integrated mental health professional. Methods: Caregivers attending their child’s 4 and 5 year-old well child visit were asked to complete a screening tool (Pediatric Symptom Checklist-17; PSC-17) measuring behavioral concerns as part of routine care. Families who screened positively, were referred to the FCU and asked to participate in a study evaluating the intervention. The FCU is a 2-session intervention during which information on home environment and parenting style was collected through tailored questionnaires, videotaped interactions, and a clinical interview. Feasibility was examined using portions of the Reach, Effectiveness, Adoption, Implementation, and Maintenance (REAIM) framework from the Dissemination and Implementation Science field. This study presents preliminary data on the domains of Reach and Adoption over the first 5 months of the FCU. Results: The number of families referred who attended at least one session (Reach) was 77.2%. Current data shows that use of the PSC-17 screening instrument (Adoption) is 91.4% for well child checks and 25% for acute visits. Adoption of those referred to the FCU is 84%, indicating most families screening positively for behavioral concerns were successfully referred to the FCU. Conclusion: Initial results suggest Reach and Adoption rates support the feasibility of adapting a behavioral intervention for delivery in the pediatric clinic. Notably, having an existing integrated care delivery model is a critical piece to this early success. Future directions will continue to explore feasibility of the remaining REAIM domains.

No description available.

L'objectif de cette thèse composée de six articles théoriques et empiriques, est d'identifier les moyens les plus efficaces d'encourager les usagers de drogues – légales et illégales – à adopter des habitudes plus saines en réduisant leur consommation. La première étape consiste à évaluer l’ampleur du problème en mesurant le coût social des drogues (tabac, alcool et drogues illicites) en France en 2010. Malgré les campagnes de prévention massives, la proportion inquiétante des consommateurs de substances nocives, mais surtout, la part élevée de personnes déclarant regretter d'avoir commencé leur consommation, conduisent à reconsidérer le paradigme traditionnel de l’addiction rationnelle, à la base de la plupart des travaux de recherche sur les addictions en économie. Au contraire, admettre une polyphasie cognitive chez les individus avec d’une part, un planner prenant ses décisions aussi rationnellement que ses capacités cognitives ne le lui permettent, et un doer ne cherchant qu’à atteindre une satisfaction immédiate, permet de construire un cadre théorique original tenant compte des émotions de court terme et de long terme des agents, ainsi que le rôle des normes sociales sur leurs décisions de consommation addictives. Le modèle construit à partir de ce cadre, ainsi que son analyse sur un panel de fumeurs français, permet de proposer des politiques novatrices visant à renforcer la motivation des individus à arrêter leur consommation addictive en réduisant leurs problèmes d’autocontrôle, en agissant sur leur perception des dangers liés à l’usage de drogues, et en ciblant un changement normatif de leur consommation. La plupart de ces recommandations ne sont pas applicables aux drogues illégales en raison de leur statut juridique. De ce fait, le seul levier permettant de définir une stratégie visant à réduire les coûts induits, est l’étude des alternatives juridiques à la pénalisation de la consommation, en particulier en ce qui concerne le cannabis, qui est la drogue illicite la plus largement utilisée en France, mais également dans la plupart des pays développés. / The objective of this thesis, composed of six academic papers, is to identify how to encourage people to adopt healthier habits by reducing their ⎯ legal and illegal ⎯ drug consumption. The first step is to evaluate the importance of the problem by measuring the social costs of drugs (tobacco, alcohol, and illegal drugs) in France in 2010. Despite massive prevention campaigns, the worrying proportion of harmful substance users and the high proportion of individuals who declare they regret having started consumption leads to reconsideration of the traditional paradigm of rational addiction and its extensions at the basis of most research works on addiction in economics. In contrast, admitting that individuals exhibit a dual process of reasoning, with a planner acting as rationally as the individual’s cognitive capabilities permit on the one hand and a doer who only seeks short-term rewards on the other, allows the construction of an original theoretical framework that takes into account consumers’ short-term and long-term emotions, and the role of social norms in addictive consumption. The model built from this framework and its testing through an analysis of smokers permit the proposal of innovative policies aiming to enhance individuals’ motivation to quit addictive consumption by (i) reducing their self-control problems, (ii) acting on their perception of the danger of the drug, and (iii) by targeting a normative change. Most of these recommendations are not applicable to illegal drugs due to their legal status. Thus, the strategy to reduce harm in this instance is to study the legal alternatives to the criminalization of use, especially for cannabis, which is the most widely used illegal drug in France, as it also is in most developed countries.

This diploma thesis deals with the issue of compulsive buying, phenomenon which is a current topic for today's society and its incidence is rising. The area of oniomania includes psychological but also social and financial aspects of the disorder. The thesis focuses mainly on the sphere of introduction of oniomania, as a great danger to man and society, especially in the context of financial illiteracy. Enough room is devoted to explication of main key words from the area of addictions (drug addictions and behavioral addictions). Attention has also been dedicated to an important chapter of the issue of gender in context to the pathological shopping and also to topics of getting to know the possibilities of treatment and prevention. The practical part of the thesis deals with research of level of awareness and orientation issues of shopping addiction among university students Using analysis of submitted questionnaires, this part of the thesis tries to find answers to fundamental questions related to the theme of financial literacy.